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Dermatosis Papulosa Nigra

Dermatosis papulosa nigra, usually shortened to DPN, is a benign condition producing small raised papules, light to dark in color, across the face and neck and sometimes the upper chest. It affects people with darker skin tones predominantly, with prevalence reaching as high as 35 percent among Black Americans, and it also occurs commonly in people of Asian descent. Lesions typically begin appearing in adolescence and increase in number with age. They are harmless and need no medical treatment, and most patients who seek treatment do so because of how they look. The clinical difficulty is specific: the same skin prone to DPN is prone to post-inflammatory hyperpigmentation, so an overly aggressive removal can trade a raised brown papule for a flat brown mark, or for a hypopigmented one. At Wall Street Dermatology, Dr. Julia Tzu removes DPN using electrodesiccation and cryotherapy with settings kept deliberately conservative for this reason. A session runs 15 to 30 minutes depending on how many lesions are being treated, small scabs heal within about two weeks, and treated lesions are gone permanently.

5 min read·Last updated: 2026-02-08·Reviewed by Dr. Julia Tzu, MD, FAAD, FACMS

At a Glance

  • Dermatosis papulosa nigra affects up to 35% of Black Americans[1]
  • DPN typically begins in adolescence and increases in number and size with age[2]
  • Treatment complications can include increased or decreased pigmentation, scarring, and keloid formation[2]
  • DPN is a benign condition that does not require treatment unless desired for cosmetic reasons[1]

What are the symptoms of Dermatosis Papulosa Nigra?

  • Small, round or oval light brown to black papules (bumps)
  • Smooth or slightly rough texture
  • Typically 1-5 millimeters in diameter
  • Usually multiple lesions
  • Common on cheeks, forehead, and around eyes
  • May also appear on neck and upper chest
  • Gradually increase in number with age
  • Painless and non-itchy

When should you seek care for Dermatosis Papulosa Nigra?

  • Raised dark spots on the face or neck that you would like removed
  • Uncertainty about whether the spots are DPN or another growth, given how similar several of them look
  • Lesions that have changed rapidly, bled, or otherwise look unlike the rest
  • Interest in discussing removal with someone who treats the condition regularly in darker skin tones
  • Growing lesion counts that are becoming harder to conceal
  • A previous removal attempt at home or in a non-medical setting that left a mark

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What causes Dermatosis Papulosa Nigra?

  • Genetic predisposition (often runs in families)
  • Related to seborrheic keratosis family of growths
  • Exact cause not fully understood
  • Not caused by sun exposure, but sun exposure may contribute to development
  • Not contagious

How is Dermatosis Papulosa Nigra treated?

We offer a service to help manage this condition: DPN Removal.

Prognosis

  • DPN lesions are completely benign
  • No risk of transformation to cancer
  • New lesions may continue to develop over time
  • Treatment complications can include hyperpigmentation or hypopigmentation
  • Scarring and keloid formation are possible risks, especially in darker skin
  • Best outcomes with experienced practitioners familiar with treating darker skin

Frequently Asked Questions

What is dermatosis papulosa nigra (DPN)?
Dermatosis papulosa nigra (DPN) is a common, harmless skin condition characterized by small, dark raised spots on the face and neck. It primarily affects people with darker skin tones, particularly those of African and Asian descent. The spots are benign and don't require medical treatment.
What causes DPN?
The exact cause isn't fully understood, but DPN has a strong genetic component and often runs in families. It's related to the seborrheic keratosis family of skin growths. DPN is not caused by sun exposure and is not contagious. It typically begins in adolescence and increases with age.
When should I see a dermatologist about DPN?
See a dermatologist if the spots bother you cosmetically and you'd like removal options, if you're unsure whether your spots are DPN or another condition, or if any spots change rapidly or look unusual. Treatment experience with darker skin tones is important for the best cosmetic result.
How is DPN treated or removed?
Treatment options include snip excision (scissor removal), curettage (scraping), electrodesiccation, cryotherapy, and laser treatment. The choice depends on the number and size of lesions. Treatment should be performed by a provider experienced with darker skin to minimize risks of scarring or pigmentation changes.
What are the risks of DPN removal?
Removal risks include hyperpigmentation (darkening) or hypopigmentation (lightening) of the treated areas, recurrence, scarring, and keloid formation–particularly in individuals prone to keloids. These risks are why it's important to choose a provider experienced in treating darker skin tones.
Can DPN be prevented?
Since DPN is primarily genetic, it cannot be prevented. The spots are benign and don't pose health risks. If DPN runs in your family, you may develop spots starting in adolescence, with more appearing over time. Treatment is purely optional for cosmetic reasons.
How is DPN removed without leaving marks in darker skin?
With restraint in the settings and patience in the sequencing. Electrodesiccation delivers a small, precisely controlled amount of energy to each papule, and cryotherapy is used selectively. The skin most affected by DPN also responds readily with pigment change when it is over-treated, so care during removal is what keeps scarring and pigment change down.
How much does DPN removal cost?
DPN removal at Wall Street Dermatology starts at $1,500. Because the papules are benign, insurers treat their removal as cosmetic, so patients pay out of pocket.
Do the spots grow back after treatment?
Treated lesions are removed permanently. New ones continue to appear over the years, because the tendency to form them is inherited and progressive with age, so many patients return periodically for maintenance sessions rather than expecting a single permanent clearance.
What does the healing period look like?
Small scabs form over the treated papules and separate within about two weeks. Downtime is minimal and normal activity continues throughout. Sun protection during healing is the thing that most affects the final result: ultraviolet exposure on healing skin is what produces the dark marks the technique is calibrated to avoid.

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Sources & References

This article draws from 3 peer-reviewed sources.

Government & Research

Educational & General

Medically reviewed by Dr. Julia Tzu, MD, FAAD, FACMS · Last reviewed: 2026-08-19